Doctor Name: | KERRI RAYMOND |
NPI Number: | 1043608466 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | LPC914 |
Business Practice Address: | 1745 Silver Spur Rd Cheyenne, WY - 820091206 |
Business Phone Number: | 3076304729 |
Business Fax Number: | 3073694292 |
Mailing Address: | Po Box 20092, CHEYENNE |
State: | WY |
Postal Code: | 820037002 |
Phone Number: | 3076304729 |
Fax Number: | 3073694292 |
NPI Enumeration Date: | 01/07/2015 |
NPI Last Update Date: | 01/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LPC914 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |